Dodecyl creatine ester and lipid nanocapsule: a double strategy for the treatment of creatine transporter deficiency.

BACKGROUND: Creatine transporter (CT) deficiency is characterized by mutations in the gene encoding CT, leading to impaired transport of creatine at the cell membrane. Patients with this disease would thus benefit from replenishment of creatine inside the brain cells. AIM: We report a therapeutic strategy based on the use of dodecyl creatine ester incorporated into lipid nanocapsules (LNCs). MATERIALS & METHODS: The dodecyl creatine ester was incorporated in the shells of LNCs using Transcutol(®) (Gattefossé SAS, Saint-Priest, France). The interactions of dodecyl creatine ester encapsulated in LNCs with an in vitro cell-based blood-brain barrier model was studied. The entry of the dodecyl creatine ester encapsulated in LNCs and the conversion of dodecyl creatine ester to creatine in the cells were also studied in the pathological context of CT deficiency. RESULTS & DISCUSSION: We showed that these LNCs can cross the blood-brain barrier and enter brain endothelial cells. In human fibroblasts lacking functional CT, all or part of the dodecyl creatine ester was released from the LNCs and biotransformed to creatine, thus indicating the value of this strategy in this therapeutic context.

Synthesis and biological evaluation of new creatine fatty esters revealed dodecyl creatine ester as a promising drug candidate for the treatment of the creatine transporter deficiency.

The creatine transporter deficiency is a neurological disease caused by impairment of the creatine transporter SLC6A8, resulting in mental retardation associated with a complete absence of creatine within the brain and cellular energy perturbation of neuronal cells. One of the therapeutic hypotheses was to administer lipophilic creatine derivatives which are (1) thought to have better permeability through the cell membrane and (2) would not rely on the activity of SLC6A8 to penetrate the brain. Here, we synthesized creatine fatty esters through original organic chemistry process. A screening on an in vitro rat primary cell-based blood-brain barrier model and on a rat primary neuronal cells model demonstrated interesting properties of these prodrugs to incorporate into endothelial, astroglial, and neuronal cells according to a structure-activity relationship. Dodecyl creatine ester showed then a 20-fold increase in creatine content in pathological human fibroblasts compared with the endogenous creatine content, stating that it could be a promising drug candidate.